Individual
CRAIG ALLEN MOORE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
LMT
Contact information
Practice address
212 FIR ST, LA GRANDE, OR 97850-2627
(541) 663-4145
Mailing address
212 FIR ST, LA GRANDE, OR 97850-2627
(541) 663-4145
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
18313
OR
Other
Enumeration date
08/11/2020
Last updated
10/05/2022
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